The invention relates to the field of intravascular catheters, and more particularly to a method of selectively removing material from a catheter shaft to produce a strong and flexible dilatation catheter shaft.
Percutaneous intravascular procedures, such as percutaneous transluminal coronary angioplasty (PTCA), were developed to open blocked vessels with as little trauma as possible. In PTCA procedures a guiding catheter having a preformed distal tip is usually percutaneously introduced into the patient's femoral artery by means of a conventional Seldinger technique and retrogradely advanced therein until the distal portion of the guiding catheter is located within the patient's ascending aorta with distal tip of the guiding catheter seated in the ostium of a desired coronary artery. The proximal end of the guiding catheter is torqued from outside the patient to guide distal tip of the guiding catheter into the desired ostium. A guidewire is positioned within an inner lumen of an dilatation catheter and then both are advanced through the guiding catheter to its distal end. The guidewire is first advanced out of the distal end of the guiding catheter into the patient's coronary artery until the distal end of the guidewire crosses a lesion to be dilated. Then the dilatation catheter, having an inflatable balloon on the distal portion thereof, is advanced into the patient's coronary anatomy over the previously introduced guidewire until the balloon of the dilatation catheter is properly positioned across the lesion. Once properly positioned, the dilatation balloon is inflated with liquid one or more times to a predetermined size at relatively high pressures (e.g. greater than 4 atmospheres) so that the stenosis is compressed against the arterial wall and the wall expanded to open up the passageway. Generally, the inflated diameter of the balloon is approximately the same diameter as the native diameter of the body lumen being dilated so as to complete the dilatation but not overexpand the artery wall. After the balloon is finally deflated, blood flow resumes through the dilated artery and the dilatation catheter can be removed therefrom.
Commercially available intravascular balloon catheters used for angioplasty and other vascular procedures usually comprise an elongated shaft with an inflatable dilatation member on a distal portion of the shaft and an adapter on the proximal end of the shaft for the delivery of inflation fluid through an inner lumen extending through the catheter shaft to the interior of the inflatable dilatation member. Typically, the balloon catheter has an outer tubular member with a distal extremity terminating within the balloon interior and an inner tubular member with a distal extremity extending through and slightly beyond the distal end of the balloon. The annular space between the inner and outer members defines the inflation lumen in communication with the balloon interior. Alternatively, a single catheter shaft provided with a plurality of lumens can be used in place of the inner and outer membered shaft. The catheter may be typically be provided with a distal tip that is flexible and tapered.
An essential step in PTCA is maneuvering the catheter over the guidewire until the balloon on the distal end of the catheter is in the desired location within the arterial occlusion. However, maneuvering the dilatation catheter over a guidewire through small branched vessels and through the stenosis requires a distal end that is both flexible and strong, to provide a catheter which is trackable and pushable.
The removal of material from the distal tip of a dilatation catheter to increase its flexibility is disclosed in U.S. Pat. No. 4,960,410 (Pinchuk) and U.S. Pat. No. 5,514,108 (Stevens). When removing material from a catheter shaft, one difficulty has been precisely forming a cut in the catheter shaft. Mechanical and thermal cutting methods disadvantageously displace shaft material during the cutting procedure, which results in an increase in the shaft diameter. For example, mechanical cutting displaces or deforms the shaft material by physically pushing the material to one side. Thermal processing methods of cutting a shaft melt the material, and as the melted material cools it coalesces into spherical beads that are typically greater than about 0.0002 to 0.0005 inches. Such beads form at the edge of the cut, and thus increase the shaft outer diameter from its original dimension at the junction between the cut and uncut material. In the formation of a distal tip taper, previous methods, such as sanding or heat forming, may also leave rough surfaces or displaced material. Such displaced material or rough surfaces undesirably increases the shaft profile and stiffness.
What has been needed is a method of selectively removing material from a polymeric substrate in a precise and controllable manner to produce a flat cut surface without displacing shaft material that increases the shaft outer diameter. The present invention satisfies these and other needs.